Healthcare Provider Details

I. General information

NPI: 1861781254
Provider Name (Legal Business Name): CHOICE HOME MEDICAL SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 07/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 WARWICK RD
STRATFORD NJ
08084-1624
US

IV. Provider business mailing address

PO BOX 567
VOORHEES NJ
08043-0567
US

V. Phone/Fax

Practice location:
  • Phone: 562-256-9961
  • Fax: 562-256-9981
Mailing address:
  • Phone: 562-256-9961
  • Fax: 562-256-9981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES UME
Title or Position: PRESIDENT
Credential:
Phone: 562-818-7891